According to the 2002 U.S. Census, Hispanics are now the nation's largest minority group. There has also been a dramatic rise in the Hispanic end stage renal disease (ESRD) population, with the number of Hispanics on dialysis increasing by more than 70 percent between 1996 and 2001. Further growth of the Hispanic ESRD population is expected in view of the increasing size of the overall Hispanic population, a high prevalence of diabetes, and an increased incidence of ESRD in Hispanics. Despite the magnitude of this problem, little is known about earlier stages of chronic kidney disease (CKD) in Hispanics. The University of Illinois at Chicago (UIC) is one of seven clinical centers for the Chronic Renal Insufficiency Cohort (CRIC) Study, which is an NIH-sponsored multi-centered study investigating risk factors for progression of kidney and cardiovascular disease (CVD) in 3,000 participants with CKD. The CRIC Study cohort is 50 percent White and 50 percent Black. This application seeks to establish a sizable cohort of Hispanics with CKD that will be integrated into the overall CRIC Study. The overall aims of this application are: 1. To determine predictors of progression of kidney disease and subclinical CVD in Hispanics with CKD. 2. To compare rates of progression of kidney disease and subclinical CVD in Hispanics with CKD with those seen in non-Hispanic Whites and Blacks. 3. To improve the accuracy of glomerular filtration rate (GFR) prediction equations in Hispanics with CKD. To achieve these aims, we will recruit and retain 316 Hispanic participants with CKD at UIC to undergo annual visits for relevant exposures (demographics, medical history, medications, diet, cognitive function, and quality of life) and measurements of subclinical CVD and renal function. To test hypotheses of particular importance to Hispanics, this proposal will focus on issues related to visceral adiposity, inflammation, and health care disparities. The linkage of the proposed study to the CRIC Study provides an unprecedented opportunity to explore risk factors and mechanisms for CKD and CVD progression in Hispanics, which are problems of critical importance from both scientific and public health perspectives.